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DISEASES OF THE PANCREAS. � PANCREATIC HEMORRHAGE. � SYNONYM. -- Pancreatic Apoplexy. � ETIOLOGY. -- In marked hemorrhages into the pancreas the cause is obscure. In slight hemorrhages the cause can be found in their being secondary to excessive chronic passive congestion, to scurvy, purpura and also to the acute infectious diseases. It is very commonly associated with organic disease of the pancreas -- acute pancreatitis, arteriosclerosis, cysts and cancer. Traumatism has been known to cause hemorrhage, also chronic alcoholism. � SYMPTOMS. -- There is often a history in the case of the patient in apparently robust health and of the attack coming on with sudden and startling gravity. Intense pain in the epigastric region or in the lower chest, together with a sense of constriction is usually the most prominent early symptom, then there is nausea and vomiting, tympanites, dyspnea and collapse. Early and constant general evidences of internal bleeding such as an anxious countenance, restlessness, depression, yawning, pallor, cold sweat, a lowered surface temperature and a small, rapid and weak pulse. Prostration and syncope follow. � DIAGNOSIS. -- Given the sudden developed signs of a concealed internal hemorrhage, with pain referred distinctly to the epigastrium, and vomiting and rapid collapse, a probable diagnosis can be made, but rarely can one be made with certainty. � PROGNOSIS. -- Nearly all cases prove fatal within twenty-four or thirty-six hours. Death being caused from shock or by reflex paralysis of the heart, due in some cases to pressure upon the solar plexus or semilunar ganglion. Complete recovery is rare. � TREATMENT. -- According to the latest medical writers, �is to open the abdomen and relieve the tension, since the fatal result is often due to pressure and not to loss of blood. It is advised to relieve the pain by morphin and to give stimulants for the collapsed condition. Should symptoms of suppuration develop an operation is indicated.�

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DISEASES OF THE PANCREAS. � PANCREATIC HEMORRHAGE. � SYNONYM. -- Pancreatic Apoplexy. � ETIOLOGY. -- In marked hemorrhages into the pancreas the cause is obscure. In slight hemorrhages the cause can be found in their being secondary to excessive chronic passive congestion, to scurvy, purpura and also to the acute infectious diseases. It is very commonly associated with organic disease of the pancreas -- acute pancreatitis, arteriosclerosis, cysts and cancer. Traumatism has been known to cause hemorrhage, also chronic alcoholism. � SYMPTOMS. -- There is often a history in the case of the patient in apparently robust health and of the attack coming on with sudden and startling gravity. Intense pain in the epigastric region or in the lower chest, together with a sense of constriction is usually the most prominent early symptom, then there is nausea and vomiting, tympanites, dyspnea and collapse. Early and constant general evidences of internal bleeding such as an anxious countenance, restlessness, depression, yawning, pallor, cold sweat, a lowered surface temperature and a small, rapid and weak pulse. Prostration and syncope follow. � DIAGNOSIS. -- Given the sudden developed signs of a concealed internal hemorrhage, with pain referred distinctly to the epigastrium, and vomiting and rapid collapse, a probable diagnosis can be made, but rarely can one be made with certainty. � PROGNOSIS. -- Nearly all cases prove fatal within twenty-four or thirty-six hours. Death being caused from shock or by reflex paralysis of the heart, due in some cases to pressure upon the solar plexus or semilunar ganglion. Complete recovery is rare. � TREATMENT. -- According to the latest medical writers, �is to open the abdomen and relieve the tension, since the fatal result is often due to pressure and not to loss of blood. It is advised to relieve the pain by morphin and to give stimulants for the collapsed condition. Should symptoms of suppuration develop an operation is indicated.�